Epidemiology and future trend predictions of ischemic stroke based on the global burden of disease study 1990–2021

Visualizing the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 and predicting future disease burdens at global, regional, and national levels can help health policymakers develop evidence-based ischemic stroke (IS) prevention and cure strategies. We stratify epidemiological parameters by sex, age, the World Bank’s classification of economies, and sociodemographic index (SDI) levels. We use frontier analysis to assess whether the burden of ischemic stroke (IS) in each country aligns with its level of economic development. We apply the Autoregressive Integrated Moving Average (ARIMA) model and the Bayesian age-period-cohort (BAPC) model to predict the burden of IS over the next 15 years. Here we show that IS accounts for 69.9 million prevalent cases, 7.8 million incident cases, 3.6 million deaths, and 70.4 million DALYs in 2021. In men, the global DALY rate of IS increases up to age 90–94 years and then decreases; however, for women, the rate increases up to the oldest age group (≥95 years). Regionally, we find that the association between the SDI and the age-standardized DALY rate of IS starts relatively flat, with a small peak up to a sociodemographic index of about 0.7, and then declines rapidly. Factors contributing most to the DALY rates for IS are high systolic blood pressure, high LDL cholesterol, and air pollution. The disease burden of IS in medium-high SDI countries is still high, which means we could not meet the Sustainable Development Goal targets by 2030. Countries should formulate prevention and control measures suitable for their national conditions based on risk factors. Ischemic stroke (IS) occurs when blood flow to part of the brain is reduced or stopped by a blood vessel becoming blocked. We assessed death, prevalence, mortality, disability, and risk factors related to people experiencing IS between 1990 and 2021 in 204 countries and territories and predicted how these might change in the future. Globally, IS accounted for 3.6 million deaths in 2021. Although the frequency of occurrences of IS and deaths due to IS has decreased over the past three decades, the absolute number of ISs is increasing as a result of population growth and population aging. The main risk factors include high systolic blood pressure, high low-density lipoprotein cholesterol, and air pollution. Our data could be useful at the global, regional, and national levels to help health policymakers develop evidence-based IS prevention and care strategies. Liu, Xu, Zhao, Ren, Hei, Fang et al. assess morbidity, prevalence, mortality, disability, risk factors, and epidemiological trends of ischemic stroke for the period 1990–2021 in 204 countries and territories. Visualizing GBD databases predicts future disease burdens at global, regional, and national levels.